The Pickett House Family Care Home

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

MHL-032-376 Issued in NC

Legal business name

THE PICKETT HOUSE FAMILY CARE HOME

Practice address

1913 Lamar St
Durham, NC 27705-3310

Phone

(919) 403-9644

Fax

(919) 489-8489

NPI assigned

Jan 9, 2007

Last updated

Jul 21, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cornell Jones

Title

Administrator

Phone

(919) 403-9644

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• TCHS Day Activity Program Other name

Tax ID family

Pickett Grove Supervised Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pickett Grove Supervised Living

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Durham, NC
  • NPI 1669689766
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216598400000",
    "number": "1083763940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 PICKETT RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277055331",
            "telephone_number": "919-403-9644",
            "fax_number": "919-489-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 LAMAR ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053310",
            "telephone_number": "919-403-9644",
            "fax_number": "919-489-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PICKETT HOUSE FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-07-21",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CORNELL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-403-9644"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": "MHL-032-376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408619",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TCHS Day Activity Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• The Mental Health Association in North Carolina, Inc (Community House II-Durham)
• The Nachman Center for Well Being, PLLC
• The Nail Institute Inc (Trendy Nailz Institute)
• The North Carolina Institute for Health Technologies, Inc (Carolina Healthcare Network)
• The Perfect Nurse, LLC
• The Springs
• The Tenderfire Project PLLC
• The Tree of Life Counseling Center
• The United Methodist Retirement Homes, Incorporated
• The United Methodist Retirement Homes, Incorporated (Croasdaile Village Home Care)

• Developmentally Disabled Services Day Training Agency in Durham, NC
• Providers in Durham, NC by specialty
• Developmentally Disabled Services Day Training Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.